Medical Journal of Babylon

Aim of the study : this study was conducted to compare the clinical symptoms of chronic maxillary sinusitis ,
plain x-ray ( Water\'s view) , CT scan of the maxillary sinuses and the results of antral lavage .
Material and Methods: 150 patients had been examined at the otolaryngology department of Al-Diwaniya
teaching hospital and diagnosed as chronic maxillary sinusitis.
Plain x-ray ( Water\'s view ) and CT scan done to all of these patients. Radiological features of chronic sinusitis
found in 118 patients , 84 bilateral (71% ) and 34 unilateral (29% ) , the radiological findings classified as
well aerated , mucosal thickening , fluid level, haziness and complete opacity .
Antral lavage done to 202 sinus and return classified to be clear, mucoid , mucopurulent and frank purulent .
Results: plain x-ray and CT scan show sinus opacity in 32 patients (16%) , haziness 80 patients ( 39 % ) ,
fluid level 54 patients ( 27% ) , mucosal thickening 36 patients (18%).
False negative plain x-ray found in 8 patients ,while false positive found in 14 patients . The antral lavage
return was 100% purulent in opaque sinus , while hazy sinus shows 50% purulent , 31% clear , 19% mucoid .
Fluid level 80% purulent , 18.5% mucoid , 1.5% clear .
Mucosal thickening 55.5% clear , 44.5% mucoid return .
Conclusions: radiological findings of maxillary sinus opacity is the most reliable evidence of sinus infection
followed by fluid level .
Water\'s view gives good information about sinus pathology but CT scan is the most sensitive radiographic
modality for the diagnosis of chronic sinusitis.

Background : Cigarette smoking is a major ‘preventable’ cause of morbidity and mortality worldwide.
Most adult smokers start smoking regularly some time before 18 years of age.
Objectives : This study aimed at identify the prevalence of, and determine some of socio-demographic
correlates of current cigarette smoking among in-school adolescents in Kut City.
Methodology : We carried out a cross-sectional survey of 1067 students in classes 7th to 11th (ages: 13 to
20 years) in 14 intermediate and secondary schools in Kut City, Wasit Province in 2007, by using
multistage probability sampling technique (stratified – simple), an anonymous self-completion
questionnaire as a part of Global School-based Student Health Survey ‘GSHS’ questionnaire was used.
Results : Results shows that cigarette smoking prevalent among male school students only, where 22.6%
(140 student of 619) stated that they had smoked at least once and (13.4%, 83 student of 619) stated that
they were currently smoking, so the data analysis involve male students only (sample size = 619). The
percentage of students who were currently smoking increased gradually with age: 7% in 13-14 years old,
16% in 15-17 years old to 29% in 18-20 years old. Findings indicates that adolescents who had parents who
smoked, were more likely to be smokers compared to adolescents who did not have parents who smoked ‘P
<0.05’ this suggests that parents imitation plays an important role in initiation of smoking in adolescents.
Fortunately, students who perceived parental supervision were less likely involved in smoking behavior ‘P
<0.05’.
Conclusion : Smoking is highly prevalent among secondary school male students in Kut City, while, there
are no smokers among female students, and this is due to the behavior of a socially acceptable habit of
smoking for men only and is not acceptable for women, and this gives immunity against the prevalence of
smoking among female students. The smoking behavior of adolescents influenced by complicated
interactions of varying sets of factors such as age, gender, parental smoking and parental supervision.

orthodontics, prosthodontics, and oral surgery. It also is of interest to anthropologists and other students of
human oral biology. The aim of this study was to compare the transverse dimensions of the dental arches of
Class III groups with a group of untreated normal occlusion subjects. This study was performed using
measurements of dental casts of 41 Class III malocclusion (21 males and 20 females) and 50 normal Class
I occlusion (25 males and 25 females), of Iraqi adult samples aged (14-24 )in Hilla city. The dental and
arch width dimensions measured were intercanine, intermolar, and molar alveolar in both arches were taken
and independent-samples t-test was applied for comparing the groups. The finding from this investigated
indicated that,(1) there are no significant differences in all measurements between Class I and Class III
overall samples except for the maxillary molar alveolar width (UA6-6) are found to be significantly larger
in Class I than in Class III overall samples and the mandibular intercanine width (L 3-3) are found to be
significantly larger in Class III than in Class I overall (2) there are no significant differences in all
measurements between Class I and Class III male samples except for the mandibular intercanine width (L
3-3) are found to be significantly larger in Class III than in Class I males (3) the lower intermolar width
(L6-6) and the lower molar alveolar width (LA6-6) are significantly larger in Class III than in normal Class
I female samples while the Class I are significantly larger than Class III females in the upper intercanine
widths (U3-3) and in the upper molar alveolar width (UA6-6), whereas the lower intercanine widths (L3-3)
and the upper intermolar width (U6-6) show no significant difference between normal Class I and Class III
female samples (4) the upper intercanine widths (U3-3) ; the upper intermolar width (U6-6); and the lower
intercanine widths (L3-3) are significantly larger in males than in females of Class III samples while the
upper molar alveolar width (UA6-6); the lower intermolar width (L6-6) ; and the lower molar alveolar
width (LA6-6) show no significant difference between males and females of Class III samples.

Deep dorsal defects of fingers are common problems which often seen in emergency units, and there are several
methods of treatments for reconstruction. In our prospective study composed of seven patients with dorsal defects of
fingers in different sites at Al-Wasiti hospital in which reconstruction were performed by the use of dorsal
adipofascial turnover flaps. By this technique we use this flap from the dorsal aspect of the finger which is raised
from the base of the base of the proximal phalanx to cover the full thickness defect as a one stage procedure. Our
results were good the flaps survived completely, the mean follow up was 6 months. This technique proved to be
simple, did not require the use of distant flap or a flap from adjacent digits, ready availability & it s Single and
simple procedure with no significant donor site morbidity. Our results and complications were comparable with
other studies which were carried for reconstruction of deep dorsal defects of the fingers.

We compared in this study the in vitro potency of some antibiotics when used singly and in combination
against the multi-drugs resistant Staphylococcus aureus using the wells diffusion in agar. Rifampin,
vancomycin, tetracycline and trimethoprim-sulfamethoxazole were randomly selected for this study. The
isolate of S. aureus used in this study was previously characterized in our laboratory as methicillinresistance
Staphylococcus aureus-MRSA carrying the mec-A gene which is responsible for methicillin
resistance.
Tremendous potencies were observed when the antibiotics used in combination compared with each
antibiotic alone. The inhibition zone of vancomycin plus rifampin was 28 mm. in diameter compared with
18 mm. and zero (fully resistance) for vancomycin and rifampin respectively. Like rifampin, trimethoprimsulfamethoxazole
was inactive per se, since no inhibition zone was seen but when combined together, the
inhibitory action significantly increased up to 19 mm. in diameter. Furthermore, combination of
tetracycline with trimethoprim-sulfamethoxazole scored an inhibition zone as high as 43 mm. compared
with 30 mm. for tetracycline alone (data for the later combination are not shown in this paper)*.

Thirty patients (age range 10-70 years), (14) 46.7% males and 16 (53.3%) females, all of them
presented with abnormal renal functions were studied in Basrah General Hospital during the period from
(March to November 2007), for evaluate safety of halothane anesthesia during routine investigations to
elective surgeries under general anaesthesia(the common use of halothane known to cause hepatotoxicity),
In addition, drugs like analgesics and antibiotics are, also, heavily used particularly in the postoperative
period. Several of these drugs can compromise renal functions, five milliliters from venous blood were
taken before operation and then immediately after the operation, and on the first and third day
postoperatively. Blood was tested for (blood urea nitrogen (BUN), serum creatinine and serum uric acid),
using appropriate kits. Seventeenth (56.7%) had repeated exposure to halothane by underwent previous
surgeries, and 13 (43.3%) are newly exposed to halothane. No significance change had been observed in
relation to gender of patients for all parameters. We conclude that laboratory values immediately after
surgical operations and for 3 days later have no trend for a major derangement in patients with renal
diseases.

Objectives: To put the light on surgical treatment of high Fistula-in- ano by using the seton and a trial to
know it's importance.
Material and methods: A retrospective study of 72 patients, their age range 19-57 year the mean age 34.2,
all of them were male except one female, with a high fistula-in-ano collected within a period of 14 years
from Jan.1995 to Dec. 2008,57 patients diagnosed during operation by simple probing while 15 of them
were diagnosed by contrast x-ray (fistulogram).The lower part of the fistula was excised while a thread put
around the high part .
Result: The time was needed range from 2-6 weeks for seton to cut completely and drops away this true
for all except one who cut the seton and disappeared. All the rest got a sound healing and no reported
recurrence.
Conclusion: It is appeared from this study that seton is an excellent surgical way for the treatment of high
fistula-in-ano.

Osteoarthritis common disease of knee joint , due to aging specially after age of 40 , it disorder of synovial joint .the glucosamine and chondrotin provide much of the resistance to compression and its used now for the treatment .the aim of this study to show the effect of this dietary supplement in knee osteoarthritis ,between 2006 &2008 in merjan teaching hospital 120 patients was selected according to ACR criteria & divided in two groups 60 for each ,they examined and follow-up regularly for six months ,group [1] given the dietary supplement ,the other given NSIAD [meloxicam],the knee joints of both groups examined at regular interval to show the response according to different parameter ,the functional score show improvement 31 while group [2] show 26 and the visual analogue score was more improved in group [1] than in group [2] and the radiological score show no difference In this study the dietary supplement show rapid improvement with maximum at 4 months while other group show improvement at 2 months with no more improvement , the side effect in group [1] were less in group [2]. The glucosamine and chondrotin should be uswd as alternative drugs tn NSAIDs because less side effect and better response in different functional score.

The etiology of duodenal ulcer (D.U.) is completely Unknown; however .Gastric acid secretion plays
an important role in pathogenesis of the disease. The study is planned to find out the relationship between
the contributing factors of D.U. and some variables, such as age, sex; level of education . It was a descriptive
study was conducted in Baghdad teaching hospital. Reviewing (30) D.U. patients who were admitted to the
surgical world of Baghdad teaching hospital. Data were collected though the use of the questionnaire
(interview) with the patients.
The results have revealed that the majority of the samples were from heavy smokers of alcoholic male.
It was recommended that an educational program for duodenal ulcer patient should be developed regarding
Duodenal ulcer.

Background: Admission of a child to the Pediatric Intensive Care Unit (PICU) can create high parental
and other companions psychological problems. Many factors contribute in a negative way to this
abnormality. Hospital Anxiety and Depression Scale (HADS) has been used to help physicians to identify
these care givers at risk and address contributing factors.
Methods: The HADS has been administered to 42 care givers (26 in PICU and 16 as a control group in a
general pediatric ward) in Babylon Gynecology and Children Teaching Hospital after their staying in
hospital for 14 days. Factors which may have an effect on psychological status have been studied.
Results: Fifteen care givers (57.7%) show depression and anxiety in the range of (11-21) according to
HADS compared to only 2 (12.5%) of the control group<0.05. All care givers think their patients are in
pain and all complained of noise in the PICU as causes of their distress. Twenty four patients were under
ventilator, fourteen care givers (93.3%) fall in the (11-21) range according to HADS..
Conclusion: Care givers in the PICU were at more risk of psychological stress compared to the control
group and there are stressful factors playing a significant role in aggravating this abnormality.

Pheromone-inducible plasmid transfer is an important mechanism for dissemination of antibiotic resistance
and virulence factors in these organisms. Plasmid-free strains of Enterococcus faecalis secrete at least half
a dozen peptide sex pheromone-probably many more-that induce a mating response by potential donor
strains carrying members of specific families of conjugative plasmids. The response is associated with
synthesis of surface proteins that facilitates formation of donor-recipient mating aggregates. When a
recipient acquires a given plasmid , the corresponding pheromone becomes shutdown or masked. Although
the structure of at least five of these peptides has been determined.

Objective: Pleural effusion is accumulation of plural fluid by different mechanisms. Thoracocentesis is
associated with subjective improvement in many patients. The results of spirometric and haemodynamic changes
after this procedure are controversial.We aimed to study the effect of therapeutic thoracocentesis on patients with
pleural effusion by assessment of spirometric values and haemodynamic changes (blood pressure assessment).
Materials and methods: This is a prospective study done in the medical ward, at Al Sader teaching hospital from 1st
march to the end of September 2008. Pleural effusions were documented clinically and by CXR. Pulmonary
function was performed with a computed Spirometric analyzer. Spirometric measurements for forced expiratory
volume in the first second (FEV1), forced vital capacity (FVC), forced expiratory volume in the first second percent
(FEV1)%, and peak expiratory flow rate (PEF) were performed according to the American Thoracic Society
criteria and blood pressure measurements were also done. The lung function test (spirometric assessment) and
blood pressure measurement were repeated 24 hours after thoracocentesis. The data were analyzed by using the
SPSS Version l0, X2 (Chi square) and a (p-value of <0.05) was regarded as statistically significant.
Results: The study population consisted of 20 patients 10(50%) male and 10(50%) female with a mean
age of 59.25 years , average weight 58.15 Kg, average height 154.85cm and average of pleural aspirate
1367.5cc, Pulmonary function (spirometer) before thoracocentesis ( FVC/1.47,FEV1/1. 21,
FEV1%84.92,PEF2.52)and pulmonary function (spirometer) post-thoracocentesis (FVC/1.841,FEV1
1.503 ,FEV1%82.845,PEF2.9)
Conclusion: Statistically significant improvement in spirometric values following thoracocentesis was
observed in patients with pleural effusion while no changes in blood pressure measurements

Aneurysms of the superficial temporal artery (STA) are a rare and potentially critical cause of facial
masses. Usually, these aneurysms are Pseudoaneurysm and occur following blunt or penetrating trauma to
the head or following surgery in the temporal region. Most cases (about 75%) are the result of blunt head
injury. Only 11 cases of spontaneous aneurysms were reported. These aneurysms are assumed to have been
congenital or arteriosclerotic. Pseudoaneurysm has occurred mainly in the anterior branch of the STA. The
first case of a STA Pseudoaneurysm was described by Thomas Bertholin in 1740 and since then about 400
cases have been published in the literatures. I present two cases of traumatic pseudoaneurysm of the STA
and I discuss pertinent diagnosis and treatment options, as well as provide a brief review of the anatomy
and histopathology of pseudoaneurysms.

Background: Seizure is the commonest neurological manifestation in the neonatal period, and usually it
shows an underlying problem in the brain due to brain damage and developmental defect in the central
nervous system. As CT(computed tomography ) scan is more reliable, more sensitive and more specific in
determining underlying brain lesion that cause seizure like ischemia, hemorrhage and brain structural
dysgenesis, so it became an important tool in assessment of neonatal convulsion.
Aim of study : To find abnormality in CT scan which are the possible causes for neonatal convulsion .
Patients and methods :A descriptive study ,performed for 70 neonates referred for CT scan of the head
from period of the first of the January 2008 to the first of April in 2010 in AL-Diawanyia teaching hospital
in Iraq after good history information, clinical examination and paraclincal investigation. All informations
are collected in check list, including time of occurring seizure & underlying causes. CT scan(Siemens)
used is with multiple axial sections, after general anesthesia to the neonate .
Results :From 70 neonates with neonatal seizures 28 were female and 42(60%) were male, 39 neonates
have normal CT scan and 31 have abnormal CT scan such as brain dysgenesis, intracranial hemorrhage,
brain ischemia and cerebrites.
Conclusion :High incidence of abnormal CT scan (87.5%) in seizure occurring during the first 72hours.
Among those positive CT scan of brain hypoxic ischemic was found in (45.9%) .

Lichen planus (LP) is a unique, common, pruritic, inflammatory disease of the skin, mucous membranes
and hair follicles. The exact pathogenesis of LP is unknown, but it is evident that immunologic mechanisms
almost certainly mediate the development of LP. Cell mediated immunity plays the major role in triggering
the clinical expression of the disease. Both CD4 and CD8 T-cells are found in lesional skin of LP. Low
dose, low molecular weight heparin (enoxaparin) has been proven effective in various types of Lp.
Enoxaparin has been shown to inhibit the expression of heparanase enzyme that is produced by CD4
lymphocytes (this enzyme is crucial in T-cell migration to target tissue).
The Aim: is to evaluate the efficacy of low-dose enoxaparin in treatment of Iraqi patient with recalcitrant
LP that is unresponsive to traditional courses of topical and systemic steroid therapy.
Methods: Fifteen patients with recalcitrant LP were included in this study Enoxaparin was given to each
patient in a dose of 3mg subcutaneous injection every week for a period of 20 weeks. Assessment of
response to treatment was done for each patient every two weeks by assessment of the severity of itching
and reduction in the number of lesions. VAS score used to assess improvement of itching. Patients divided
into 3 groups (mild LP, moderate LP, and severe LP) according to the number of lesions at initial
presentation. Response to treatment classified for 4 grades (no response, mild response, moderate response,
dramatic response).
Results: There was dramatic reduction in VAS score in 13 patients of the 15 patients
(86.6%). This reduction is considered statistically significant in the end of the 1st month of treatment (pvalue
0.0002). The number of patients that respond to therapy in the end of treatment course was 12
patients (80%), this include all grades of improvement (mild 26.6%, moderate 20%, and dramatic 33.33%).
patients with mild type LP showed a response of (83.33%) which is higher than the response rate of
moderate type LP (71.42%).
Conclusions: Enoxaparin is effective, safe, simple and good alternative therapy for acute and chronic
recalcitrant lichen planus, specially those who complain from severe itching, those who use prolonged
courses of steroid therapy without benefit and those with hypertrophic type LP

Objective: To determine the effects of a single dose of dexamethasone on post-operative morbidity in
patients undergoing tonsillectomy and/or adeno-tonsillectomy.
Design: prospective, double-blinded, placebo-controlled clinical trail.
Methods: In a period between February 2007 to January 2010 one hundred sixty patients (94 male and
66 female),aged between 4 and 42 years,undergoing tonsillectomy and/or adenoidectomy were randomized
to receive a single dose of intravenous dexamethasone 0.4 mg/kg or 8 mg for adult or placebo saline single
dose postoperatively and were assessed for post operative pain, nausea and vomiting, tolerance to oral
intake, uvular edema, fever and the time of discharge from hospital.
Result: The use of inject able dexamethasone in a dose 0f 0.4 mg per kg body weight for children or 8 mg
for adult was effective in reducing post operative undesirable symptoms like pain, nausea, vomiting, edema
, inadequate oral intake and fever.

A retrograde personal study of 12000 girls and women were attended the private clinic, gynecology clinic
and infertility clinic in Babylon from 1978 to 2009 was made .
The age group varied from 21 to72 years.
It involved all stages of life ,before marriage ,late marriage ,during or without pregnancy and after
menopause.
The main symptoms were abdominal distension ,dull ache, menstrual disorders mainly bleeding ,infertility.
During pregnancy pain and miscarriage.
In my experience and follow up of the cases recurrence of the tumors occurred once or many time , patients
succeed to get pregnancy after removal of the tumor but malignant change or transformation were
minimum or negligible while on the whole the tumors were mostly benign in nature.
All surgical complication treated and assisted by the surgeon.